The precise impact of cardiovascular risk factors (CVRF) on the right ventricle-pulmonary circulation unit remains unclear.

With the sudden onset of the COVID-19 pandemic, countries rushed to implement guidelines for triage. Some were unprepared. In Germany, academic discourse had focused on criteria for triage, while often neglecting their translation into clinically applicable protocols in intensive care units (ICUs).

Pulmonary arteriovenous malformations (PAVMs) require therapeutic embolization and careful surveillance to prevent serious complications including stroke, brain abscess, and hemoptysis. While initial treatment guidelines are well established, post-treatment surveillance practices remain heterogeneous, with no standardized approach for monitoring treated lesions or detecting PAVM persistence. This variability in follow-up care may impact patient outcomes, particularly in high-risk populations such as those with Hereditary Hemorrhagic Telangiectasia (HHT).

Pulmonary hypertension (PH) is a complex, life-threatening condition requiring non-invasive, accessible, and accurate diagnostic tools, particularly in resource-limited settings. Early and precise identification of PH and its subtypes is critical for effective management and timely intervention.

Increasing evidence supports lung cancer screening with low-dose computed tomography (LDCT). However, the benefits of LDCT screening for lung cancer may not be immediate, making it unlikely to benefit patients with limited life expectancy.

Establishing the cause of a pleural effusion can be challenging. Analysis of pleural fluid is a powerful tool to determine the etiology of a pleural effusion. Surprisingly, despite the diagnostic power pleural fluid analysis (PFA), it is often underused. The purpose of this review is to provide a practical framework to maximize the diagnostic potential of the PFA. In this manuscript we will describe the role of a PFA in establishing the cause of a pleural effusion. We will also discuss challenges and limitations of PFA.

A 54-year-old woman with a history of recurrent exertional dyspnea for 5 years was admitted for evaluation. Six months prior, she noted a worsening of her symptoms, with progressive physical activity limitation caused by exertional fatigue and dyspnea (climbing 2 to 3 flights of stairs). She also experienced palpitations, with an estimated heart rate that ranged from 120 to 150 beats per minute. The patient denied chest pain, hemoptysis, or other notable symptoms. Notably, the patient underwent surgical repair of an atrial septal defect more than 20 years earlier, with a good postoperative recovery. Regular postoperative echocardiograms revealed no residual shunt, no valvular abnormalities, and no pulmonary hypertension. The patient had no history of smoking, drug abuse, or alcohol consumption.

A 94-year-old man presented with a 1-day history of dyspnea and no infective symptoms. There was no associated chest pain, cough, or fever. Systemic review was negative for loss of appetite or weight. He had a medical history of ischemic heart disease with an ejection fraction of 45%, hypertension, hyperlipidemia, and Alzheimer dementia.

A 47-year-old woman initially presented with recurrent coughing caused by the ingestion of gritty foods such as nuts over 20 years ago. Subsequently, she experienced frequent postprandial episodes of white sputum containing food particles and suffered from acid reflux and heartburn, which were originally overlooked.

Pulmonary alveolar proteinosis (PAP) is a rare lung condition characterized by the accumulation of proteinaceous material within the alveoli. The acquired form is often autoimmune, driven by autoantibodies against granulocyte-macrophage colony-stimulating factor. Presentation of autoimmune PAP may range from incidental detection in asymptomatic patients to advanced respiratory failure. Treatment typically involves whole lung lavage or granulocyte-macrophage colony-stimulating factor therapy in symptomatic patients; spontaneous resolution is rare in severe cases. Here, we report 3 cases of autoimmune PAP who presented with resting hypoxia and exhibited spontaneous resolution without significant treatment. All 3 cases had a history of occupational inhalational exposure to noxious gases, and they improved following sustained cessation of exposure. We hypothesize that occupational or environmental noxious inhalation exposure may have a role in disease expression in some cases of autoimmune PAP, and such cases may show spontaneous resolution following cessation of the offending exposure.

There is increasing recognition that health behaviors may contribute to outcomes following COVID-19, but information on the role of alcohol use is limited.

Identifying biomarkers is vital for interstitial lung disease (ILD) management and prognostication. While anti-Ro52 antibodies are frequently detected in autoimmune diseases, their significance in ILD remains unclear.

Surrogates are often required to participate in the informed consent process for critical care research, though how to best engage surrogates in this process remains unclear.

Pulmonary hypertension (PH) is a high-risk finding in end-stage kidney disease (ESKD) and independently associated with increased mortality.

Functional status and frailty are important considerations in lung transplant (LT) candidacy due to the potential impact on post LT outcomes. Once listed, waitlist duration can be unpredictable, and preservation of functional capacity is thus critical to prevent deterioration in conditioning. Pulmonary rehabilitation (PR) has been deemed to be a cornerstone of management of chronic lung disease, and its role is often emphasized in lung transplantation.

The routine use of computed tomography and lung cancer screening has increased the incidence of peripheral pulmonary lesions (PPLs). Sampling may be needed for some nodules. Many new technologies are available to improve the diagnostic performance of bronchoscopy for the sampling of PPLs, but few comparative trials exist. The objective of this study was to compare the diagnostic performance of bronchoscopy with radial endobronchial ultrasound (rEBUS) using an ultrathin bronchoscope (BF-MP190F, Olympus) with a non-ultrathin bronchoscope, and to compare the diagnostic performance of bronchoscopy with and without rapid on-site evaluation (ROSE).

Becoming a clinician requires not only the accumulation of medical knowledge but also the development of a professional identity. The humanities may illuminate how professional and personal experiences shape identity, support meaning-making, and foster resilience through reflection and creative expression.

Challenges facing health care professionals (HCPs) in selecting an inhaled medication-delivery system for patients with chronic obstructive pulmonary disease (COPD) include: 1. numerous maintenance medications and combinations; 2. at least 22 different handheld inhaler devices; 3. management recommendations focusing mainly on classes of medications; 4. lack of knowledge about available medications/combinations, delivery systems, and guidelines/expert recommendations for treating patients with COPD; 5. in some countries, contracts between health insurance and pharmaceutical companies limit which medications-devices are covered. In this article we address three considerations for HCPs related to treating patients with COPD: selecting an inhaled delivery system; assessing whether the inhaled medication-device has provided symptomatic benefit; and providing educational materials for patients on how to use their prescribed medication-device correctly. Four patient cases are presented to illustrate these clinical aspects. The main patient factors for selecting an inhaled delivery system include cognitive function, manual dexterity, and inhalation ability. Continuity of the type of handheld inhaler can be beneficial if the patient is using it correctly. To assess the efficacy of the inhaled medication-device at follow-up, HCPs can ask the patient, "Does your current treatment help your breathing?" If the response is Yes, it is appropriate to continue the therapy and to also review inhaler technique; if the response is No, then the next step is to assess the patient's inhaler technique as well as adherence. If the patient demonstrates and/or describes good technique, is adherent, and does not report subjective benefit, it is reasonable to change the medication and/or device.

Airway inflammation is a hallmark feature of asthma characterized by elevated eosinophils and/or neutrophils. Eosinophils in sputum can contribute to ventilation defects. The functional consequence of other types of cellularity on ventilation is unknown.

Pulmonary embolism (PE) is one of the leading causes of pregnancy-related deaths in high-income countries. Maternal mortality from PE has been attributed to delayed recognition and investigations. The diagnosis of PE may be challenging, as its early signs and symptoms may overlap with physiologic changes of pregnancy. As such, promptly ruling out suspected PE using diagnostic testing is of paramount importance. In this narrative review, we provide a contemporary overview of risk assessment tools, diagnostic modalities, counseling needs, and existing best practice guidance for the diagnosis of PE in pregnancy.